Breathe easy: Taking control of asthma

August 19, 2010 By Michael J. McNamee, M.D.

If you have asthma, you know how frightening it can be to suffer an acute attack. Recognizing early symptoms of an attack and taking prompt action before they worsen is key to avoiding a health emergency.

Is it asthma?

The symptoms of asthma include difficulty breathing, chest tightness, coughing and wheezing. Severe attacks may cause sweating, increased pulse rate and extreme anxiety. If breathing is so labored that the body can't get enough oxygen, the face and lips may turn blue.

During an asthma attack, breathing is restricted by three physical changes that occur in the lungs, usually as a reaction to an allergen (a substance that can cause an allergic reaction). The most critical factor is the inflammation (swelling) of the lining of the air passages in the lungs. In addition, cells lining the passages produce more mucus than usual, and the muscles of the airways tighten. Together, these changes make it difficult to breathe.

Allergens from dust, molds, pollen and animal dander can trigger an asthma attack. So can air pollutants, such as cigarette smoke, exhaust fumes, paint fumes, smog and smoke from a wood fire. Having a cold or a respiratory infection brings on asthma attacks in some people. Exercise, changes in weather and certain foods can do the same. Some people with asthma are sensitive to pain relievers, including aspirin and ibuprofen, or to dusts or chemicals they're exposed to at work.

How asthma is treated
There are many drugs available to treat asthma. The two most common types are anti-inflammatories (used to reduce swelling in the lining of the air passages) and bronchodilators (used to relax muscles in the air passages).

Although each of these drugs can be used to both prevent and treat asthma attacks, anti-inflammatories are most often used to prevent attacks and bronchodilators to treat attacks in progress.

A severe attack may require hospitalization. Once admitted, patients may need to be connected to a ventilator (a machine that does the work of breathing) and given drugs designed to relax the chest muscles.

Ease the wheeze
Try these smart strategies from the National Asthma Education and Prevention Program's latest guidelines to control the condition:

Schedule regular visits to your healthcare provider. Asthma can change over time. Even if your condition seems to be under control, your healthcare provider should monitor you regularly to make sure your treatment is appropriate.

Create an asthma action plan. It's a how-to on taking your medicines, preventing flare-ups, recognizing and treating an attack and seeking emergency care.

Tame your triggers. Many asthma cases can be traced back to specific allergens such as smoke, pollen, mold, animal dander, feathers, dust, food and cockroaches. What you can do:

Quit smoking and don't allow anyone to smoke in your home.

Cover mattresses and pillows in special dust mite–proof covers.

Wash bedding and stuffed toys weekly in hot water (over 130 degrees).

Avoid humidifiers, which can make mold and dust mite problems worse.

Use a dehumidifier to keep humidity between 30 percent and 50 percent.

Remove carpeting from your bedroom.

Treat existing conditions. Seek medical help if you have sinusitis, gastroesophageal reflux (heartburn) or obstructive sleep apnea; feel stressed or depressed; or are overweight or obese. All can aggravate asthma.

Take your medicines as prescribed. Certain medications are better for sudden attacks, while others are meant to control your condition long term. Ask your doctor about all your options.

Michael J. McNamee, M.D., is director of the Division of Pulmonary/Critical Care Medicine at the Hospital of Central Connecticut. For referrals to HCC physicians, please contact our free Need-A-Physician referral service at 800.321.6244.